RT Journal Article
T1 Impact of cumulative body mass index and cardiometabolic diseases on survival among patients with colorectal and breast cancer: a multi-centre cohort study.
A1 Kohls, Mirjam
A1 Freisling, Heinz
A1 Charvat, Hadrien
A1 Soerjomataram, Isabelle
A1 Viallon, Vivian
A1 Davila-Batista, Veronica
A1 Kaaks, Rudolf
A1 Turzanski-Fortner, Renee
A1 Aleksandrova, Krasimira
A1 Schulze, Matthias B
A1 Dahm, Christina C
A1 Tilma Vistisen, Helene
A1 Rostgaard-Hansen, Agnetha Linn
A1 Tjønneland, Anne
A1 Bonet, Catalina
A1 Sanchez-Perez, Maria-Jose
A1 Colorado-Yohar, Sandra
A1 Masala, Giovanna
A1 Palli, Domenico
A1 Krogh, Vittorio
A1 Ricceri, Fulvio
A1 Rolandsson, Olov
A1 Lu, Sai San Moon
A1 Tsilidis, Konstantinos K
A1 Weiderpass, Elisabete
A1 Gunter, Marc J
A1 Ferrari, Pietro
A1 Berger, Ursula
A1 Arnold, Melina
K1 Body mass index
K1 Breast cancer
K1 Cardiovascular disease
K1 Cohort study
K1 Colorectal cancer
K1 Comorbidity
K1 Cumulative exposure
K1 Diabetes
K1 Survival
AB Body mass index (BMI) and cardiometabolic comorbidities such as cardiovascular disease and type 2 diabetes have been studied as negative prognostic factors in cancer survival, but possible dependencies in the mechanisms underlying these associations remain largely unexplored. We analysed these associations in colorectal and breast cancer patients. Based on repeated BMI assessments of cancer-free participants from four European countries in the European Prospective Investigation into Cancer and nutrition (EPIC) study, individual BMI-trajectories reflecting predicted mean BMI between ages 20 to 50 years were estimated using a growth curve model. Participants with incident colorectal or breast cancer after the age of 50 years were included in the survival analysis to study the prognostic effect of mean BMI and cardiometabolic diseases (CMD) prior to cancer. CMD were defined as one or more chronic conditions among stroke, myocardial infarction, and type 2 diabetes. Hazard ratios (HRs) and confidence intervals (CIs) of mean BMI and CMD were derived using multivariable-adjusted Cox proportional hazard regression for mean BMI and CMD separately and both exposures combined, in subgroups of localised and advanced disease. In the total cohort of 159,045 participants, there were 1,045 and 1,620 eligible patients of colorectal and breast cancer. In colorectal cancer patients, a higher BMI (by 1 kg/m2) was associated with a 6% increase in risk of death (95% CI of HR: 1.02-1.10). The HR for CMD was 1.25 (95% CI: 0.97-1.61). The associations for both exposures were stronger in patients with localised colorectal cancer. In breast cancer patients, a higher BMI was associated with a 4% increase in risk of death (95% CI: 1.00-1.08). CMDs were associated with a 46% increase in risk of death (95% CI: 1.01-2.09). The estimates and CIs for BMI remained similar after adjustment for CMD and vice versa. Our results suggest that cumulative exposure to higher BMI during early to mid-adulthood was associated with poorer survival in patients with breast and colorectal cancer, independent of CMD prior to cancer diagnosis. The association between a CMD diagnosis prior to cancer and survival in patients with breast and colorectal cancer was independent of BMI.
PB BioMed Central Ltd.
YR 2022
FD 2022-04-11
LK http://hdl.handle.net/10668/20280
UL http://hdl.handle.net/10668/20280
LA en
NO Kohls M, Freisling H, Charvat H, Soerjomataram I, Viallon V, Davila-Batista V, et al.  Impact of cumulative body mass index and cardiometabolic diseases on survival among patients with colorectal and breast cancer: a multi-centre cohort study. BMC Cancer. 2022 May 14;22(1):546.
NO The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark); German Cancer Aid, German Cancer Research Center (DKFZ), Federal Ministry of Education and Research (BMBF), Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy and National Research Council (Italy); Health Research Fund (FIS), PI13/00061 to Granada; PI13/01162 to EPIC-Murcia), Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, and the Catalan Institute of Oncology (Spain).This study was in part funded by Wereld Kanker Onderzoek Fonds (WKOF), as part of the World Cancer Research Fund International grant programme (IIG_2016_1636, Principal Investigator: Isabelle Soerjomataram), by the World Cancer Research Fund (WCRF UK) as part of the World Cancer Research Fund International grant programme (IIG_2019_1978, Principal Investigator: Heinz Freisling), and by the French National Cancer Institute (INCA_ N°2020-087, Principal Investigator: Heinz Freisling).
DS RISalud
RD Apr 18, 2025